Sorry for the confusion regarding the type of suppmt given to d/c'd premies.
I made the assumption upon reading Lyla's initial post that she was referring
to formula  "enhancement" of  EBM upon d/c, not necessarily   a suppmt called
"HMF" which I agree, is limited to hospital use.
In this area (Boston hospitals), and with the population that I see as a VNA
nurse, premies that have had a level 2 or 3 nsy stays are routinely (and more
commonly now than in the past) d/c'd having had less experience at breast and
with suppmtation by a  "premie D/C formula". They are most often given
explicit instructions to brfd only 1-2X day and are uniformly left with the
impression that the brfdng is "tiring", "burns too many calories" and because
of its composition (less of alot of components that the d/c formula "offers")
AND inability to measure, is too risky an endeavour at the time of D/C.  Of
course, many of these babies ie. the earlier, more fragile, those who don't
feed well or have Moms with production issues (to name a few!) will need and
benefit by suppmtation.  However, different neos from different hospitals
have very different ideas on suppmts-how much for how long etc. and this
results in alot of confusion amongst those of us that are trying to support
these families.
Of course this brings us back to the original question which is; "how
definitive is this recent research?" Before we put the breastfdng success of
this population at even greater risk, we do need, as Kathleen suggests, to
design a study that compares the groups through methodology that is
meaningful to those of us that *have a clue* and know the difference between
*breastfed* and *optimally breastfed*.  I would love to take part in
this-feel free to email me privately or through the group!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

Kathleen wrote;
>>ynn, good idea for a study. Any takers here? We need to add to the body of
evidence here, as professionals in this field.  Perhaps one of you has
access to this population, and professionals to collaborate with? The only
way this work gets done is if someone realizes the limitations of previous
work and adds to it with new vigor and dimension.

There is very little fear of sacrificing breastfeeding, because it is a
loaded subject for most people, for health professionals in specific.
Breastfeeding, whether we did or didn't, whether we support it or not,
whether we help our patients by giving good information or by protecting
and patronizing them, is a complex product of  our own feelings as parents,
and our own beliefs and parenting practices. Evidence, as we have stated
before, has very little to do with the practice of most people. It will be
used if it supports what we *want*, but if it does not, we can safely shut
the drawer and forget it. Kathleen

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